Staff report working under more pressure and feeling less able to deliver a good quality service. They feel less enthusiastic about their jobs and more dissatisfied with pay, the survey results reveal.

Janet Davies, Chief Executive of the RCN, said: “These figures bear out the warnings from frontline nurses – patient care standards are heading in the wrong direction and nursing staff will not accept it. But it also reveals the sharpest ever rise in dissatisfaction with pay, now standing at 45% of the workforce – up by more than 7% in a single year. It is a reminder that years of unfair pay deals have taken their toll and a meaningful rise is long overdue.

“When two-thirds of NHS workers say they cannot do their job properly due to understaffing, ministers must listen. Safe and effective staffing levels are crucial – standards of patient care rise and fall along with the number nurses on duty. Patients can pay the highest price when levels fall too low – legislation is needed to ensure accountability.

“More than half of NHS staff report working unpaid overtime every single week. Ministers must stop treating the goodwill and dedication of NHS staff as a replacement for adequate funding and proper workforce planning. Continuing down this path is unfair, and untenable.”